Characterization of spontaneous malignant lymphomas in Japanese macaques (Macaca fuscata)

Lymphomas are common spontaneous tumors in nonhuman primates but remain poorly characterized in Japanese macaques (Macaca fuscata). This study examined 5 cases of spontaneous malignant lymphoma in Japanese macaques, focusing on the immunophenotypes and presence of simian lymphocryptoviruses, which are Epstein-Barr virus-related herpesviruses in nonhuman primates. The macaques with lymphoma were 5 to 28 years old, indicating that lymphomas develop over a wide age range. The common macroscopic findings were splenomegaly and enlargement of lymph nodes. Histologic and immunohistochemical analyses revealed that all cases were non-Hodgkin type and exhibited a T-cell phenotype, positive for CD3 but negative for CD20 and CD79α. The lymphomas exhibited diverse cellular morphologies and were subdivided into 3 types according to the World Health Organization classification. These included 3 cases of peripheral T-cell lymphoma, not otherwise specified; 1 case of T-cell prolymphocytic leukemia; and 1 case of an unclassifiable T-cell lymphoma. Positive signals were detected by in situ hybridization in 2 of the 4 examined cases using probes for the Epstein-Barr virus-encoded small RNA (EBER). Furthermore, the presence of M. fuscata lymphocryptovirus 2, a macaque homolog of Epstein-Barr virus, was demonstrated in EBER-positive cases by polymerase chain reaction amplification followed by direct sequencing. Immunohistochemistry using antibody to the Epstein-Barr virus-encoded nuclear antigen 2 was negative, even in the EBER-positive cases. The present study suggests that T-cell lymphoma is more common than B-cell lymphoma in Japanese macaques and that M. fuscata lymphocryptovirus 2 is present in some cases.

Serum DJ-1 level is positively associated with improvements in some aspects of metabolic syndrome in Japanese women through lifestyle intervention

DJ-1 is a protein that is associated with Parkinson disease and cancer, and the reduction of DJ-1 function and expression is also thought to be a cause of diabetes and hypertension. However, little is known about the association between the plasma concentration of DJ-1 and risk of metabolic syndrome. We hypothesized that a lifestyle intervention would increase serum DJ-1 and that up-regulated DJ-1 functions will result in the prevention of metabolic syndrome. The objective of our study is to examine whether the level of serum DJ-1 is associated with the risk of metabolic syndrome. Therefore, to reveal the association between DJ-1 and metabolic syndrome, this study investigated lifestyle intervention in a control group (n = 37) and intervention group (n = 45). The results showed that body mass index, body fat ratio, waist-hip ratio, waist circumference, blood pressure, and plasma glucose level were improved in the intervention group, as compared with those in the control group. Furthermore, serum levels of DJ-1 were increased in the intervention group, when compared with those in the control group. These results suggest that serum DJ-1 is increased by lifestyle intervention and that increased serum DJ-1 prevents metabolic syndrome. Thus, the level of serum DJ-1 will become one of the indexes for the risk of metabolic syndrome.

Recurrence of chronic pulmonary aspergillosis after discontinuation of maintenance treatment by antifungal triazoles

OBJECTIVE

To assess the prevalence and risk factors of recurrence of chronic pulmonary aspergillosis (CPA) after discontinuation of antifungal triazoles.

METHOD

We reviewed the medical records of CPA patients who achieved resolution of clinical and radiographic manifestations and stopped taking antifungal triazoles between June 2006 and June 2012 at Tokyo National Hospital. We evaluated whether there was CPA recurrence within 1 year after treatment cessation and investigated risk factors for relapse. The association of anti-Aspergillus antibody conversion with CPA recurrence was also reviewed.

RESULTS

A total of 39 patients were included in this study and there was CPA recurrence in 14 patients. Compared with the Non-recurrence group, the Recurrence group exhibited 1) younger age (p = 0.017), 2) more than one lung lobe affected by CPA more frequently (p = 0.008), 3) longer duration needed to remit manifestations of chest radiograph (p = 0.031), 4) longer antifungal treatment duration (p = 0.042). The present study did not reveal an association between negative conversion of serum anti-Aspergillus antibody and recurrence risk. Multivariate logistic regression analysis revealed that patients with CPA with affected area of more than one lung lobe had increased risk (odds ratio, 10.20; 95% confidence interval, 1.49-69.77; p = 0.018).

CONCLUSION

CPA recurrence can be seen in about one-third of cases after discontinuing azole treatment. We should make decisions about treatment duration and follow up depending on the severity of each case, particularly on the expansion of CPA-affected area.

Chronic thromboembolic pulmonary hypertension complicated by a cavitating lung infection caused by Mycobacterium intracellulare

A 35-year-old man with a six-month history of progressive exertional dyspnea was referred to our institution. He had been diagnosed with Mycobacterium intracellulare pulmonary infection with lung cavitation two years earlier, and was being followed up without any medications. After being referred to our hospital, he underwent computed tomographic pulmonary angiography, which indicated a pulmonary thrombus and lung cavitation. Furthermore, right heart catheterization confirmed pulmonary hypertension, and we made a diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH). Following successful pulmonary endarterectomy, the patient's symptoms and hemodynamics were significantly improved, with the disappearance of lung cavitation. It is important to suspect CTEPH in patients with unaccountable infectious lung cavities.

Sentinel and nonsentinel lymph node assessment using a combination of one-step nucleic acid amplification and conventional histological examination

BACKGROUND

Clinical significance of intraoperative sentinel lymph node (SLN) metastases detection using one-step nucleic acid amplification (OSNA) has not been thoroughly investigated. The aim of this study was to assess the usefulness of using a combination of OSNA and conventional histological examinations.

MATERIALS AND METHODS

We included 772 consecutive patients with clinical node-negative cTis-cT3 primary breast cancer who underwent SLN biopsy with intraoperative OSNA and multi-section histological examination at our institution. We estimated the concordance rate and compared SLN metastases detection rates between the two methods. We also compared non-SLN metastasis detection rate between patients who tested positive in OSNA and those who tested positive in histology.

RESULTS

Among 772 patients, SLN metastases were intraoperatively detected in 211 (26.4%) by either OSNA or histology, in 168 (21.8%) by OSNA, and in 150 (19.4%) by histology. The concordance rate between OSNA and histological examination was 89.2%, but only 123 (58.8%) patients tested positive in both OSNA and histology; 45 were positive in OSNA only and 43 were positive in histology only. SLN status as per both OSNA and histology was significantly correlated with the presence of non-SLN metastases and multivariate analysis-identified independent predictive factors of non-SLN metastases.

CONCLUSIONS

Intraoperative SLN metastases detection may be more accurate with a combination of OSNA and histological examination than with OSNA or histological examination alone. By using both methods, we can reduce the risk of false negative rate in SLN biopsy, and may prevent physicians from overlooking patients with non-SLN metastases.

Abstract 37: Multiplexed mutational profiling of Japanese lung adenocarcinoma patients for personalized cancer therapy

Background: Integration of genotype-based stratification into the lung cancer clinic is essential to implement the personalized medicine for patients with lung adenocarcinoma. Thus we have developed a multiplexed tumor genotyping panel for detecting somatic mutations relevant to molecular targeted therapies for lung cancer. The mutation profile data are communicated to clinicians to assign patients to appropriate therapy and/or clinical trials.

Methods: Multiplexed tumor genotyping panel was developed to assess 23 mutations in 9 genes (EGFR, KRAS, BRAF, PIK3CA, NRAS, MEK1, AKT1, PTEN and HER2), 5 genes amplifications (EGFR, MET, PIK3CA, FGFR1 and FGFR2), and 5 fusion genes (EML4-ALK, CD74-ROS1, SLC34A2-ROS1, KIF5B-RET and CCDC6-RET) using pyrosequencing plus capillary electrophoresis, qRT-PCR, and multiplex RT-PCR, respectively. A written informed consent was obtained upfront from all patients enrolled into this study. Surgically resected tissues, tumor biopsies, pleural effusions and/or pericardial effusions from 280 patients were collected between July 2011 and July 2012 and used for tumor genotyping.

Results: Somatic mutations were detected in 52.9% (148/280) of all patients. The most common mutation detected in this study was EGFR mutation (35.4%, 99) followed by KRAS mutation (10.4%, 29). EGFR L858R (52.5%) and KRAS G12C (44.8%) was the most frequent among EGFR and KRAS mutations, respectively. Other detected mutations were PIK3CA mutation (2.5%), PIK3CA amplification (2.5%), EGFR amplification (2.5%), MET amplification (2.1%), EML4-ALK fusion gene (1.4%), BRAF mutation (1.1%), NRAS mutation (1.1%), HER2 mutation (1.1%), MEK1 mutation (0.7%), AKT1 mutation (0.7%), KIF5B-RET fusion gene (0.4%), CD74-ROS1 fusion gene (0.4%) and FGFR1 amplification (0.4%). EGFR tyrosine kinase inhibitor (EGFR-TKI) was administered to 71.9% (41/57) of previously untreated patients who harbor EGFR activating mutations. Among those treated with EGFR-TKIs, simultaneous mutations in other genes with EGFR mutations were detected in 21.9% (9/41). Response rate of EGFR-TKIs in patients with simultaneous mutations (44.4%) was lower than that in patients with EGFR mutation alone (68.8%), suggesting that additional mutations may play some role in evading oncogenic signaling blockade. EGFR mutations were detected less frequently in smokers than in never-smokers (25.1% vs 60.5%, p<0.0001). Meanwhile, KRAS mutations were detected more frequently in smokers than in never-smokers (13.6% vs 2.5%, p=0.0043), which is consistent with previous reports. The majority of patients with never-smoking history harbored targetable somatic mutations compared to those with smoking history (71.6% vs 45.2%, p<0.0001).

Conclusions: We have established the multiplexed tumor genotyping panel and this should be incorporated into lung cancer clinical practice to facilitate personalized cancer medicine.

Citation Format: Masakuni Serizawa, Yasuhiro Koh, Hirotsugu Kenmotsu, Mitsuhiro Isaka, Akane Naruoka, Junko Suzuki, Masaru Watanabe, Masahiro Endo, Takashi Nakajima, Shoji Takahashi, Yasuhisa Ode, Tateaki Naito, Tetsuhiko Taira, Akira Ono, Toshiaki Takahashi, Nobuyuki Yamamoto. Multiplexed mutational profiling of Japanese lung adenocarcinoma patients for personalized cancer therapy. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 37. doi:10.1158/1538-7445.AM2013-37

Function of feline signaling lymphocyte activation molecule as a receptor of canine distemper virus

Morbilliviruses use signaling lymphocyte activation molecule (SLAM) as a receptor for their entry to cells. In this study, a complete gene encoding SLAM of a domestic cat was identified. The identity of feline SLAM with canine one was 73%, and feline SLAM formed the same cluster with those of carnivores. Furthermore, feline cell expressing feline SLAM supported growth of canine distemper virus (CDV) as well as that expressing canine one. These results indicated that feline SLAM can function as a receptor for morbilliviruses, and our established feline cells that express feline SLAM might be useful for analysis of morbilliviruses originated from felids.

Developmental and epigenetic anomalies in cloned cattle

Many of the developmental anomalies observed in cloned animals are related to foetal and placental overgrowth, a phenomenon known as the 'large offspring syndrome' (LOS) in ruminants. It has been hypothesized that the epigenetic control of imprinted genes, that is, genes that are expressed in a parental-specific manner, is at the root of LOS. Our recent research has focused on understanding epigenetic alterations to imprinted genes that are associated with assisted reproductive technologies (ART), such as early embryo in vitro culture (IVC) and somatic cell nuclear transfer (SCNT) in cattle. We have sought and identified single nucleotide polymorphisms in Bos indicus DNA useful for the analysis of parental-specific alleles and their respective transcripts in tissues from hybrid embryos derived by crossing Bos indicus and Bos taurus cattle. By analysing differentially methylated regions (DMRs) of imprinted genes SNRPN, H19 and the IGF2R in cattle, we demonstrated that there is a generalized hypomethylation of the imprinted allele and the biallelic expression of embryos produced by SCNT when compared to the methylation patterns observed in vivo (artificially inseminated). Together, these results indicate that imprinting marks are erased during the reprogramming of the somatic cell nucleus during early development, indicating that such epigenetic anomalies may play a key role in mortality and morbidity of cloned animals.

Doctor's delay in endobronchial tuberculosis

OBJECTIVE

The aim of this study was to investigate the current status of doctor's delay in diagnosing endobronchial tuberculosis (EBTB) and to elucidate the risk factors contributing to the delay.

METHODS

Retrospective clinicopathological analysis.

PATIENTS

Sixty-two patients with EBTB were admitted at our hospital between 1999 and 2010. Their backgrounds, symptoms, diagnoses at initial consultation, delay in diagnosis, and clinical examination results were analyzed.

RESULTS

Of the 62 patients, 59 had acid-fast, bacillipositive sputum smear test results at admission. Among the 40 patients with total diagnostic delay of more than 2 months, only 11 experienced long patient's delay exceeding 2 months. However, 22 patients experienced long doctor's delay of more than 2 months (28% vs. 55%, respectively, p < 0.05), suggesting that doctor's delay contributes more to total delay than patient's delay. Fever was less frequent in patients with long doctor's delays than in those without (0% vs. 18%, respectively), at the initial consultation. In addition, radiographs showed that patients with long doctor's delays more frequently presented with shadows in the lower lung field (50% vs. 23%, p < 0.05), and most of these patients had noncavitary shadows on admission. All 7 patients diagnosed with bronchial asthma at the initial consultation had long doctor's delays.

CONCLUSION

These findings demonstrate that long doctor's delays in diagnosing EBTB remain an issue. The clinical features of EBTB with long doctor's delays were confirmed to be quite different from those of pulmonary tuberculosis.

Muscle biopsy findings predictive of malignancy in rare infiltrative dermatomyositis

OBJECTIVE

The characteristic pathological muscular findings of polymyositis (PM) and dermatomyositis (DM) have been shown to reflect their different pathogeneses. Here, we characterized the muscle biopsy findings of PM and DM patients with or without malignancy.

METHODS

We evaluated the muscle biopsy findings of 215 consecutive PM and DM patients admitted to our hospital between 1970 and 2009. Pathology of the lesion biopsy sections was classified into 3 types: endomysial infiltration-type, perivascular infiltration-type, and rare-infiltrative-type.

RESULTS

There was no difference between the muscle pathology of PM patients with and without malignancy. However, the incidence of rare-infiltrative type muscle pathology in DM patients with malignancy was significantly higher than in those without such tumors (p=0.0345).

CONCLUSION

The incidence of rare-infiltrative type muscle pathology may be a predictive marker of DM with malignancy.

Characterization of a novel Entamoeba histolytica strain from Burkina Faso, Africa, possessing a unique hexokinase-2 gene

An Entamoeba histolytica strain (BF-841 cl1) that originated from Burkina Faso, Africa presented with novel, polymorphic genotypes of the serine-rich E. histolytica protein and the anodic hexokinase-2 (HXK-2) isoenzyme band, which showed less electrophoretic mobility than that of an E. histolytica reference strain [HM-1:IMSS cl6 (zymodeme (Z)-II)] by starch gel electrophoresis and isoelectric focusing (IEF). The HXK-2 gene of BF-841 cl1 had amino acid variations at four positions compared to the sequence of HM-1: IMSS cl6. These variations were absent from the sequences of four other E. histolytica strains with different zymodemes [KU27 (Z-II), SAW1627 (Z-IIα-), SAW755CR clB (Z-XIV), and KU2 (Z-XIX)]. The results of IEF showed no difference in the substrate specificity of HXK (HXK-1 and HXK-2) between BF-841 cl1 and the three reference E. histolytica strains (HM-1:IMSS cl6, SAW755 clB, and KU27). It was also confirmed that BF-841 cl1 was able to form liver abscesses in Syrian hamsters.

Abstract 3802: Effect of CS-7017, a selective PPARδ agonist, on the TGFβ/Smad-mediated enhanced cell motility of EGFR-tyrosine kinase inhibitor-resistant non-small cell lung cancer cells

Background: CS-7017, a novel selective peroxisome proliferator-activated receptor gamma (PPARδ) agonist of thiazolidinedione class, has been reported to induce morphological change and cellular differentiation as well as its antiproliferative effects. A phase II clinical trial of CS-7017 in combination with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) erlotinib is currently ongoing in advanced non-small cell lung cancer (NSCLC) patients. Though EGFR-TKIs are effective for NSCLCs with EGFR-activating mutations, the majority of responders eventually develop acquired resistance. We have previously reported that EGFR-TKI-resistant NSCLC cells acquire enhanced cell motility via activation of TGFβ pathway. In this study, we aim to investigate the effects of CS-7017 in EGFR-TKI-resistant NSCLC cells with a focus on cell motility. Materials and Methods: Erlotinib-resistant PC-9ER and gefitinib-resistant PC-9/ZD cells, established from PC-9 NSCLC cells with EGFR-activating mutation, were used for this study and constitutive PI3K/Akt activation and the EGFR T790M mutation have been previously shown to account for the acquired resistance, respectively. Growth-inhibitory effect of CS-7017 was evaluated by MTT assay. Wound closure assay and transwell assay were performed to evaluate the cell motility. The levels of TGFβ1 and 2 secretion were quantified by ELISA. Cellular mRNA levels of TGFB1 and TGFB2 were measured by qRT-PCR. Smad- or PPARδ-mediated transcriptional activity was analyzed by luciferase assay. Effects of CS-7017 on the molecules relevant to EGFR, TGFβ and PPARδ pathways were observed by immunoblot analysis. Results: Both PC-9ER and PC-9/ZD resistant cells showed the enhanced cell motility resulting from TGFβ2-induced activation of TGFβ pathway. CS-7017 showed significant inhibitory effect on the cell motility of the resistant cells but showed no growth-inhibitory effect. Moreover, combination treatment of CS-7017 and erlotinib resulted in better inhibition of the cell motility of PC-9ER cells. CS-7017 treatment was found to suppress the TGFβ2 secretion significantly resulting from downregulation of TGFB2 at transcriptional level and attenuated Smad2 phosphorylation was observed in the resistant cells. Smad-mediated transcriptional activity was also suppressed by CS-7017 treatment. CS-7017 treatment induced PPARδ-mediated transcriptional activity in PC-9 and PC-9/ZD cells but not in PC-9ER cells, suggesting that the inhibitory effect of CS-7017 on the cell motility of PC-9ER cells may not be due to direct activation of PPARδ signaling by CS-7017. Conclusions: These results imply that CS-7017 may serve as a potential therapeutic agent to prevent metastasis in NSCLC patients who develop acquired resistance to EGFR-TKIs regardless of the types of resistance mechanisms.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3802. doi:1538-7445.AM2012-3802

Abstract 1735: Evaluation of a novel flow cytometry-based system for the detection of circulating tumor cells

Background: The presence and number of circulating tumor cells (CTCs) in the blood of solid tumor patients is predictive of clinical outcome. To date the CellSearch system is the only FDA-approved CTCs enumeration system for advanced breast, prostate and colon cancers. However, sensitivity issues due to EpCAM-based enrichment and limited capability for subsequent molecular analysis need to be addressed for the use of CTCs in the clinical setting. We have developed a flow cytometry-based CTCs detection system independent of EpCAM expression which allows enumeration and characterization of CTCs for multiple molecular analyses. Here we report the results of preclinical study with this novel flow cytometry-based CTCs detection system. Materials and Methods: EpCAM-positive gastric cancer cell line KATO-III and lung cancer cell line PC-9 and EpCAM-negative lung cancer cell line A549 were used for this study. Cells were spiked into 1 mL or 4 mL of peripheral blood from healthy donors. Samples were negatively enriched using anti-CD45-coated magnetic beads to remove white blood cells followed by fixation and labeling with Alexa Fluor 700-CD45, PE-EpCAM and/or FITC-cytokeratin (CK) antibodies. The number of cancer cells in the enriched sample was counted using a novel FISHMAN-R flow cytometry system. CTCs enumeration and a head-to-head comparison with CellSearch system were carried out in a blinded manner at two different sites, Shizuoka cancer center (SCC) and National cancer center Tokyo (NCC) in parallel. Results: Various numbers of KATO-III and PC-9 cells were spiked into 1 mL of blood for a pilot study and sensitivity in detection was evaluated. Recovery rate ranged from 108.8 to 160.0% for KATO-III and from 70.0 to 74.7% for PC-9 cells, respectively. Good correlation was observed between the observed number and the expected number of cancer cells by regression analysis demonstrating a slope of 1.07 and a correlation coefficient (R2) of 0.99 for KATO-III and a slope of 0.75 and R2 of 1.00 for PC-9 cells, respectively. Then we proceeded to the spike-in experiment in 4 mL of blood and this study was performed at two different sites. Recovery rate ranged from 89.0 to 120.0% at SCC and from 88.0 to 130.0% at NCC, respectively, suggesting the robustness of our detection system. In the following head-to-head comparison study with CellSearch system in a blinded manner, the average recovery rate was 90.3% at SCC, 87.6% at NCC and 62.0% by CellSearch system, respectively. EpCAM-negative lung cancer cell line A549 cells were also spiked into 4 mL of peripheral blood and enumerated by our system and CellSearch system. Markedly higher recovery rate was observed with our system (91.9%) than with CellSearch system (28.8%), suggesting superior sensitivity of our system in capturing EpCAM-negative tumor cells. Conclusions: These data imply the potential of our detection system and further evaluation with clinical samples should be conducted.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1735. doi:1538-7445.AM2012-1735

Search for antihelium with the BESS-Polar spectrometer

In two long-duration balloon flights over Antarctica, the Balloon-borne Experiment with a Superconducting Spectrometer (BESS) collaboration has searched for antihelium in the cosmic radiation with the highest sensitivity reported. BESS-Polar I flew in 2004, observing for 8.5 days. BESS-Polar II flew in 2007-2008, observing for 24.5 days. No antihelium candidate was found in BESS-Polar I data among 8.4×10(6) |Z|=2 nuclei from 1.0 to 20 GV or in BESS-Polar II data among 4.0×10(7) |Z|=2 nuclei from 1.0 to 14 GV. Assuming antihelium to have the same spectral shape as helium, a 95% confidence upper limit to the possible abundance of antihelium relative to helium of 6.9×10(-8)} was determined combining all BESS data, including the two BESS-Polar flights. With no assumed antihelium spectrum and a weighted average of the lowest antihelium efficiencies for each flight, an upper limit of 1.0×10(-7) from 1.6 to 14 GV was determined for the combined BESS-Polar data. Under both antihelium spectral assumptions, these are the lowest limits obtained to date.